Acceptance and Commitment Therapy for Parenting Children With Cerebral Palsy

The psychological flexibility will be assessed using the 7-item Acceptance and Action Questionnaire-II (AAQ-II). Each item in the AAQ-II is scored on a scale of seven from 1(never true) to 7(always true). The total score is obtained by summing the scores of all items, and the higher the total score indicates greater psychological inflexibility.

The psychological distress outcomes including, anxiety, depression, and stress will be assessed using the self-report 21-item anxiety, depression, and stress scale (DASS-21).

Each of the subscales comprises 7 items and is scored on a four-point Likert scale ranging from 0(didn't apply at all to me) to 3(applied to me very much or most of the time), and the score is calculated by summing up the items in each subscale, and the final core is obtained by multiplying the core by two to make it comparable with the full scale (DASS-42). The higher the core indicates high distress symptoms.

The quality of life will be evaluated by using the World Health Organization Quality of Life-BREF (WHOQOL-BREF).

It comprises four domains: physical health, psychological, social relationships, and environment. Each item is scored on a five-point scale from 1 to 5, with varying response options across the domains, and some items need to be reversely scored. There are two items examined separately and will not be included in the score calculation. Domain scores are calculated by summing up the mean of all items in each domain and multiplying by four, and then the total score is transformed to a 0-100 scale to make the domains comparable. A higher the score indicates a higher QOL.